Swim Lessons and Hypotonia

Hypotonia is a condition commonly known as “floppy baby.”

I found the wikipedia entry to be excellent and drastically expanded my understanding of the condition when working with swimmers. Looking back, I know that this is what one family tried to tell me about that i didn’t realize the full extent of.

A reader sent me a question about how to deal with hypotonia in a 7 year old and this is my expanded response.

I’ve had a number of swimmers with Hypotonia, though I wasn’t aware of the official name. They said it was, “low muscle tone,” which I thought was weak, or in the body building sense, not enough muscle because they didn’t grow it quickly. That they needed extra training. I was so wrong.


Hypotonia is resistance to passive movement, whereas muscle weakness results in impaired active movement.

Some things to remember.

Hypotonia is a condition for which diet, exercise, or training will NOT fix. It is, in general terms, a delay of the muscles to contract, or stretch.

When we’re teaching swimmers the participant with hypotonia won’t be able to move their bodies in exactly the way we ask. They’ll have difficulty translation thought and will into action.

They may *want* to do a freestyle stroke, but b/c their muscles delay action, do not tighten fully, and won’t clench like most people, they’ll be slower, more “limb” like where their arms move like bones instead of putting pressure against the water and feeling the push of fluid resistance.

To teach hypotonia swimmers, give them large macro motions. Less fine precision actions may be easier to accomplish than specific complicated mini-movements. The muscles struggle to respond to direction, they struggle to squeeze and flex because they lack the tone, they lack the ability to behave like muscles in the rapid and immediate fashion people without hypotonia expect and rely on.

Do large arm circles instead of high elbow recovery. Look for strong kicks instead of rigid legs with floppy ankles.

Breaststroke may or may not be possible, but the large circular motions would be a better start for the kick. For the arms I’d suggest an 11, Eat, 11 pattern instead of 11, Y, Eat, 11, or sweeping out.

For fly, they’ll often do an illegal kick b/c they lack the strength, the tone, to keep their legs pinned together doing the same thing.

The key is that the swimmer will have to adapt to swimming. They might not be able to do the more refined nuance of swimming well, but we can get them to do the macro large motions and in time even more complicated things.

I have a hypotonia swimmer on the swim team who has moved from our beginners to developmental, to advanced age group swimming. I expect him in a few years to be on the swim team in high school.

Good luck! I hope this helps!

A few more quotes from the article which I found extremely helpful:


Muscle tone vs. muscle strength[edit]

The low muscle tone associated with hypotonia must not be confused with low muscle strength or the definition commonly used in bodybuildingNeurologic muscle tone is a manifestation of periodic action potentials from motor neurons. As it is an intrinsic property of the nervous system, it cannot be changed through voluntary control, exercise, or diet.”True muscle tone is the inherent ability of the muscle to respond to a stretch. For example, quickly straightening the flexed elbow of an unsuspecting child with normal tone, will cause their biceps to contract in response (automatic protection against possible injury). When the perceived danger has passed, (which the brain figures out once the stimulus is removed), the muscle relaxes and returns to its normal resting state.“”…The child with low tone has muscles that are slow to initiate a muscle contraction, contract very slowly in response to a stimulus, and cannot maintain a contraction for as long as his ‘normal’ peers. Because these low-toned muscles do not fully contract before they again relax (muscle accommodates to the stimulus and so shuts down again), they remain loose and very stretchy, never realizing their full potential of maintaining a muscle contraction over time. ”

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